Proinsulin and age in general population

Abstract Objective. The objective of this study was to assess the relationship between fasting proinsulin (PI) and age in general population and to determine whether there are differences regarding this association in obese and non-obese persons. Methods. A random population-based sample (n=656) of Romanians (26–80 years) living in Bucharest, Romania was studied; 432 persons had diabetes and they were not analyzed in this paper. Circulating levels of fasting plasma glucose (FPG), fasting plasma insulin (FPI), fasting plasma proinsulin (FPP), fasting plasma C-peptide, HbA1c, lipid profile, creatinine, urea were measured. The homeostasis model assessment of insulin resistance (HOMA-IR), HOMA-B, and Quicki index were also calculated. Results. For all participants proinsulin was the highest in the third quartile of the age group (59-67 years), with a median proinsulin of 5.8 pmol/L. Subsequently, proinsulin increased with age, from 2.6 pmol/L for participants aged 20-51 years, to 4.7 pmol/L for participants aged 51-59 years; proinsulin levels decreased in the upper quartile 4.8 pmol/L for those aged over 67 years. In sex-specific analyses, proinsulin increased with age for both men and women, except for those in the upper quartile. The prevalence of the obesity was 30.4% (n=68); obesity prevalence did not increase with age (p=0.26). Fasting proinsulin levels significantly increased with body mass index (BMI) category from lean (n=67, 2.9 pmol/L) to overweight (n=89, 4.5 pmol/L) and obese (n=69, 6.63 pmol/L) (p<0.0001). Conclusions. Our study has demonstrated a close association between age and elevated proinsulin and proinsulin/insulin ratio in general population. Abbreviations: BMI – body mass index, BP – blood pressure, DM – diabetes mellitus, eGFR– estimated glomerular filtration rate, FPI – fasting plasma insulin, FPG – fasting plasma glucose, FPP– fasting plasma proinsulin, HbA1c – glycosylated hemoglobin, HOMA-IR – the homeostasis model assessment of insulin resistance, HOMA-B – the homeostatic model for assessment of B-cell function, IGT – impaired glucose tolerance, MetS – metabolic syndrome, PIR – proinsulin to insulin ratio, WC – waist circumference, HDL-C – high density lipoprotein cholesterol, TG – triglycerides, TC – total cholesterol, T2DM – type 2 diabetes.